Cheyenne Regional Medical Center Foundation · 3 weeks ago
Revenue Integrity Senior Director - Onsite
Cheyenne, WY
Full-time
Onsite
Director/Executive
8+ years expCheyenne Regional Medical Center Foundation is the largest hospital in Wyoming, seeking a Revenue Integrity Senior Director to lead the Revenue Integrity Division. This role focuses on maximizing revenue capture, overseeing coding and compliance processes, and driving financial improvement across the healthcare system.
Hospital & Health Care
Responsibilities
Provides strategic leadership and oversight for organization-wide Revenue Integrity and charge capture functions, ensuring alignment with organizational goals and regulatory standards
Partners with clinical departments to implement and sustain continuous performance improvement efforts that ensure accurate and compliant charge submission
Leads and executes transformational change by driving innovative, high-impact operational strategies to contribute to Cheyenne Regional’s strategic goals
Leads the annual price adjustment process through pricing models and vendor contract management variance reporting to support data-driven adjustments
Directs the management of Revenue Guardian, charge capture, reconciliation, and charge interfaces to ensure accurate charges across the healthcare organization
Collaborates with billing departments to establish and maintain charge capture audit processes, to identify coding discrepancies and mitigate revenue leakage
Partners with the Revenue Leadership Team to develop and execute advanced monitoring tools to evaluate the performance and impact of revenue cycle initiatives. Focuses on key metrics such as Accounts Receivable (AR) Days, timeliness of charge capture, Discharged Not Final Bill (DNFB), etc. while driving automation and process optimization to enhance revenue integrity and operational efficiency
Manages and oversees development of policies, processes and workflows for hospital and professional coding, reviewing coding, medical necessity and level of care denials to ensure organizational best practices
Collaborates with the Compliance department to ensure billing practice meets requirements across the health system
Oversees and manages the division’s budget and financial targets, ensuring fiscal responsibility and alignment with strategic objectives
Analyzes patient estimates and provides actionable insights to assist patient experience
Reviews, analyzes and monitors organizational dashboards to identify trends, risks, and opportunities for improvement
Collaborates with the Revenue Cycle Administrator and Medical Director of Revenue Integrity to meet organizational goals and metrics relative to charging and coding of accounts
Participates in the Billing Grievance Committee to assist in monitoring and facilitating policies and regulatory compliance while meeting patient expectations
Participates, implements, and maintains Lean Methodology within the Revenue Integrity Division
Fosters cross-functional collaboration with clinical, financial, and operational departments to ensure optimal financial performance while maintaining high standards of accuracy, compliance, and efficiency
Collaborates with the Medical Director of Revenue Integrity to engage medical staff for denial prevention and documentation improvement initiatives
Qualification
Required
Bachelor's Degree or higher in Business Administration, Health Care Administration, Clinical Administration, Finance, and/or related field
Eight (8) or more years of hospital Revenue Cycle, Revenue Integrity, and/or reimbursement experience
Seven (7) or more years of management experience, with an emphasis on project management
Ability to apply appropriate management and leadership techniques and to manage multiple staff members in an operational setting
Advanced level of communication (verbal and written), interpersonal skills, problem solving, and organizational skills to maintain a high level of production and accuracy in an extremely task driven environment
Experience using Excel, PowerPoint, and Word
Excellent ability to understand and interpret statistical reports and perform quantitative analysis
Advanced skills in critical thinking and problem solving in a variety of settings and translation of data into actionable steps
Knowledge of insurance claim processing and third-party reimbursement
Knowledge of state and federal regulations as they pertain to billing processes and procedures
Knowledge of various types of provider reimbursement methodologies including per diems, inpatient Diagnosis-Related Groups (DRG)/All Patient Refined Diagnosis Related Groups (APRDRG) case rates, percent of charges, and outpatient surgery case rate methodologies
Knowledge of Revenue Cycle processes, medical billing and coding processes, detailed accounting principles, quantitative decision making, and process analysis
Ability to work independently, delegate responsibility, and take initiative across multiple workstreams
Time management and project management skills
Preferred
Master's Degree or higher
Coding Certification to include, RHIA, RHGIT, CPC, CIC, CCA
Healthcare Financial Management Association certification
Benefits
403(b) with 4% employer match
ANCC Magnet Hospital
21 PTO days per year (increases with tenure)
Education Assistance Program
Employee Sponsored Wellness Program
Employee Assistance Program
Loan Forgiveness Eligible
Company
Cheyenne Regional Medical Center Foundation
The CRMC Foundation is a 501(c)(3) nonprofit organization in Cheyenne, Wyoming that is organized exclusively to advance and assist in the development, growth, and operation of Cheyenne Regional Medical Center.
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase